Medicare Denials

TGF provides assistance to providers whose Medicare claims are denied for various reasons.  Frequently, coverage decisions are made by intermediaries and appealed to contractors who apply local coverage determinations issued by the intermediary rather than CMS.  In order to have the issue decided without deference to local coverage determinations, providers must work through various levels of appeal.  After multiple appeals, the issue is no longer controlled by more restrictive local coverage determinations.  Getting to this point requires careful monitoring of the claim and timely appeal submissions.  Ultimately, providers will have to persuasively present their arguments to an administrative law judge.

TGF works with clients to craft arguments throughout the Medicare appeals process to ensure that medically necessary care is properly reimbursed by the federal government.


  • TGF assists providers whose Medicare claims are denied
  • TGF can work with you through the various levels of appeals
  • TGF works with its clients to craft arguments throughout the Medicare appeals process to ensure that medically necessary care is properly reimbursed by the federal government